I think the biggest cost saving you see with single payer is a significant drop in ER visits. When people dont have insurance, they dont go to the doctor with minor issues. Some of those minor issues go away, some get worse. Those that get worse eventually go to the emergency room for treatment once the problem because serious, and treating serious medical issues is significantly more expensive than preventing them.

SALEM, Ore. -- A new study has found that people enrolled recently in Medicaid went to the emergency room 40 percent more frequently than others, often seeking help for conditions that could be treated less expensively in a doctor's office or an urgent care clinic.

The findings help inform a long-running debate about the effect of expanding Medicaid and suggest that hospitals and health officials around the nation should be prepared for an increase in emergency room trips in the coming months.

The study is the third to arise from a limited expansion of Medicaid in Oregon five years ago. Demand exceeded the available funding, so the state used a lottery to randomly choose people for coverage from a waiting list. The lottery created two groups of similar people, one consisting of new Medicaid patients, the other a comparison group of people who weren't selected. It gave scientists a rare chance to evaluate the program in a randomized, controlled study -- the gold-standard for scientific research.

Taken together with the earlier findings, the latest research indicates that expanding Medicaid improves mental health and leaves patients more financially stable in the first two years. But it increases spending for hospitals, primary care and prescriptions and doesn't produce significant improvements in measures of physical health like blood pressure or cholesterol.

"We've been able to eliminate some extreme views about the program," said Sarah Taubman of the National Bureau of Economic Research, the study's lead author. "In the absence of that evidence, there were some unduly pessimistic views and some unduly optimistic views" about the effects of Medicaid.

Researchers used hospital records to look at ER use over 18 months for 25,000 people in the Portland area who entered the Medicaid lottery, some who were chosen for coverage and some who were not. Patients with Medicaid made, on average, 1.43 ER visits, compared with 1.02 for those who lost the lottery, an increase of 40 percent.

From the study it sounds like people were taking advantage of a system that they never used before. I'd like to see the study done for longer than 18 months monitoring poor people who had just been given health insurance.

Regardless, people without insurance are much less likely to have a primary physician than those with insurance, and that plays a big role in receiving proper preventative care

From the study it sounds like people were taking advantage of a system that they never used before. I'd like to see the study done for longer than 18 months monitoring poor people who had just been given health insurance.

Regardless, people without insurance are much less likely to have a primary physician than those with insurance, and that plays a big role in receiving proper preventative care

No, but that was one of the chief selling points and excuses of why healthcare costs skyrocket. It's more of an education level issue that causes people to just saunter into an ER than go to an Urgent care or NP to take care of simpler items.

From the study it sounds like people were taking advantage of a system that they never used before. I'd like to see the study done for longer than 18 months monitoring poor people who had just been given health insurance.

Regardless, people without insurance are much less likely to have a primary physician than those with insurance, and that plays a big role in receiving proper preventative care

Which is why I have said from day one fix the uninsured part first, then see how the cost controls go from there.
There isn't an ounce of pure for the greater good motives here by DC.

Totally agree a study of the poor and what they use dont use would be good data to have going forward.